Latching‐On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment

Abstract

Increasing breastfeeding duration and exclusivity is an acknowledged public health priority. Breastfeeding problems, especially with the healthy term neonate latching-on or feeding with a suboptimal latch, are common reasons for early breastfeeding termination when they result in inadequate breastfeeding, poor milk transfer, and sore nipples. This article describes clinical strategies for systematic latch-on and suckling assessment with the goal of improving the skills of clinicians who provide care for breastfeeding women.

Breastfeeding Characteristics of Late-Preterm Infants in a Kangaroo Mother Care Unit

“…For breastfeeding, rooting is important, as it gives an indication of feeding readiness and may impact on successful latching. 25,26 Latching was indeed affected in this sample. Although most latched-on (97.3%), latching was shallow, only onto the nipple or less, in 93% of participants who latched-on.…”

“…Poor latching, often highlighted in LPIs, 5,14,27 is concerning, as this may impact on the efficiency of milk transfer. 25 Immaturity in sucking and swallowing were also expected, given previous research indicating that neurological immaturity in LPIs may impact on these characteristics, and that coordinating these with breathing, only matures and is refined in the third trimester. 5,14,27,28 The suck-swallow-breathe ratio for efficient breastfeeding in term infants is 1-1-1, to 3-1-1.…”

“…26 Non-nutritive sucking creates slower milk transfer with the risk of insufficient intake if the breastfeeding session is short. 25 Although the mean length of time held for breastfeeding was 17.8 minutes (Positive skewness: 1.0), most participants were held for breastfeeding for under 10 minutes (76.7%). Typically, breastfeeding session length is not an accurate indicator of successful breastfeeding, as this may vary considerably depending on the infant.…”

“…Typically, breastfeeding session length is not an accurate indicator of successful breastfeeding, as this may vary considerably depending on the infant. 25 A short breastfeeding session may indicate an efficient breast-feeder, able to achieve sufficient milk intake in a short period. 25 The results suggest that participants, as a group, were not efficient breast-feeders and the shorter time held for breastfeeding may be an indication of poor endurance, a difficulty frequently highlighted in LPIs.…”

“…25 A short breastfeeding session may indicate an efficient breast-feeder, able to achieve sufficient milk intake in a short period. 25 The results suggest that participants, as a group, were not efficient breast-feeders and the shorter time held for breastfeeding may be an indication of poor endurance, a difficulty frequently highlighted in LPIs. 5,7,19 One explanation for poor endurance, may be the high rate of respiratory difficulties in this sample 26 (15% required oxygen at the time of evaluation and almost 50% had RDS).…”